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100 Mullins Dr Ste C1 Lebanon OR 97355-2868 | |
| (541) 451-7450 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine - Addiction Medicine |
| Location | 100 Mullins Dr Ste C1, Lebanon, Oregon |
| Authorized Official Name and Position | Daniel Rackham (CEO-SLCH) |
| Authorized Official Contact | 5417686768 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Mullins Dr Ste C1 Lebanon OR 97355-2868 Ph: (541) 451-7450 | 100 Mullins Dr Ste C1 Lebanon OR 97355-2868 Ph: (541) 451-7450 |
| NPI Number | 1003362922 |
|---|---|
| Provider Enumeration Date | 08/31/2016 |
| Last Update Date | 01/08/2025 |
| Certification Date | 01/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003362922 | NPI | - | NPPES |
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